Tetanus Surveillance — United States, 2009–2023

Problem/Condition: Tetanus is a serious but vaccine-preventable disease caused by the toxin produced by germinated spores of Clostridium tetani bacteria. Despite substantial declines in incidence resulting from immunization, cases continue to occur, particularly among unvaccinated and undervaccinated populations. Period Covered: 2009-2023. Description of System: The National Notifiable Diseases Surveillance System uses national surveillance to identify cases of tetanus using the Council of State and Territorial Epidemiologists' tetanus case definition. Tetanus cases identified through clinical diagnosis are reported to CDC by state health departments. Detailed tetanus-specific case information is requested, which includes tetanus toxoid-containing vaccine (TTCV) vaccination history, wound history, medical care before tetanus disease onset, and the clinical course of illness, including death. Results: During 2009-2023, a total of 402 tetanus cases and 37 associated deaths were reported from 47 states and the District of Columbia, with a mean annual tetanus incidence of 0.08 cases and 0.008 deaths per 1 million population. More than half (62.2%) of all reported tetanus cases occurred in males. Incidence was higher among males than females for all persons aged